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Medsurg Exam 3 > GI Disorders > Flashcards

GI Disorders Flashcards

(49 cards)

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1
Q

patho of the mouth in digestion

A

responsible for chewing with mechanical digestion

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2
Q

patho of esophagus in digestion

A

Is a hollow muscular tube that carries food & liquid from the mouth to the stomach. It does this by peristalsis.

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3
Q

patho of stomach in digestion

A
  • Stores food during eating
  • Secretes digestive fluids
  • Moves partially digested
    food (chyme) into the small intestine
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4
Q

patho of small intestine in digestion

A

digestion from stomach
absorption of nutrients

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5
Q

patho of large intestine in digestion

A

absorbs water and electrolytes from food that has not been digested yet
* defecation rids the body of any waste leftover from food and removes it through the rectum and anus

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6
Q

parts involved in digestion

A

Mouth
Esophagus
Stomach
Small and large intestine
Rectum

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7
Q

factors in a balanced diet

A

Macronutrients
-Carbohydrates, fats, proteins
Micronutrients
-Vitamins, minerals, electrolytes
Water

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8
Q

healthy diet promotion by the nurse:

A

Begins with assessment of nutritional status
Education and cultural competence are key
Social determinants of health should be part of assessment

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9
Q

Modifications made to a basic diet to meet the needs of the patient

A

modified diet

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10
Q

Used when nutrition cannot be maintained orally, but GI function intact

A

enteral nutrition

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11
Q

nutrition for when the GI tract is not functioning

A

total parenteral nutrition

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12
Q

types of modified diets

A

Clear Liquid
Full Liquid
Pureed (blenderized)
Soft (bland, low-fiber)
Mechanical Soft
Dysphagia

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13
Q

advance diet as tolerated:

A

watch how pt tolerates each diet
wait at least 2-3 hours for response

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14
Q

placement for parenteral nutrition

A

through central vein
through peripheral vein

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15
Q

placement for routes of enteral nutrition

A

stomach (nasogastric)
duodenum (nasoduodenal)
jejunum (nasojejunal)
gastrostomy (stomach)
jejunostomy (SI)

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16
Q

how is enteral nutrition administered

A

via tube to the stomach, duodenum or jejunum

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17
Q

delivery methods for enteral nutrition

A

Continuous infusion
Cyclic feeding
Intermittent
Bolus

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18
Q

Enteral Nutrition Nursing Considerations

A

Tube placement verification
Maintain patency
Presence of bowel sounds
Gastric residuals
HOB 30 degrees
Oral care

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19
Q

Enteral Nutrition Complications

A

Aspiration
N/V and abdominal discomfort
Diarrhea or constipation
Dumping syndrome - feeding too much too fast
Electrolyte imbalances

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20
Q

Nutrition provided via peripheral or central venous routes
Highly concentrated formulas of macronutrients, electrolytes, vitamins, and trace elements

Study These Flashcards
A

parenteral nutrition

21
Q

Parenteral Nutrition Nursing Considerations

Study These Flashcards
A

Monitor solution for “cracking” or separation - always send back
Double nurse verification
Monitor blood sugars Q4-6 hours
Do not administer medications or blood products in same line
If new bag is not available, administer dextrose in water
Maintain sterility
Daily weights (notify MD >1kg/day)

22
Q

Parenteral Nutrition Complications

Study These Flashcards
A

Infection and sepsis
Hyperglycemia
Electrolyte imbalances
Fluid overload
Refeeding Syndrome (respiratory, cardiac, and neuro changes)

23
Q

acute vs chronic peptic ulcer disease

Study These Flashcards
A

Acute
-Superficial erosion
-Minimal inflammation
-Short duration: resolves quickly when cause is identified and removed

Chronic
-Long duration
-Muscular wall erosion with formation of fibrous tissue
-Present continuously for many months or intermittently throughout person’s lifetime
-More common than acute erosions

24
Q

2 types of peptic ulcers

Study These Flashcards
A

duodenal - mucosis is damaged and cannot protect against damage
gastric - lining is disrupted

25
clinical manifestations of duodenal ulcers
Weight gain Pain 2-3 hours after eating pain relieved with eating Vomiting Melena Perforation
26
clinical manifestations of gastric ulcers
Weight loss Immediate pain Vomiting Hemorrhage
27
complications of PUD
Hemorrhage (dizzy, hypotension, chest pain) Perforation (fever, rebound tenderness, hard abdomen) Penetration Pyloric Obstruction
28
medications for PUD
H2R Blockers (ranitidine, famotidine) PPI (Omeprazole, Pantoprazole) Antibiotics (amoxicillin, clarithromycin) Antacids Bismuth Salts
29
treatment for PUD
Surgery Endoscopy Decompress the bowel PRBC’s Electrolyte replacement
30
nursing diagnosis for PUD
Acute pain Ineffective health management Nausea
31
overall goals for PUD
Adhere to prescribed therapeutic regimen Experience a reduction in or absence of discomfort Exhibit no signs of GI complications Have complete healing Make appropriate lifestyle changes to prevent recurrence
32
health promotion for PUD
Identify patients at risk Lifestyle changes Teach patient to report to health care provider symptoms related to gastric irritation Teach patient s/s of hemorrhage, perforation, and obstruction
33
Acute care for PUD
NPO NG tube with intermittent suctioning IV fluid replacement Explain treatment measures to patient/family Provide regular mouth care Cleanse and lubricate nares
34
Expected outcomes for PUD
Have pain control without the use of analgesics Verbalize understanding of the treatment regimen Commit to self-care and management Have no complications
35
terms under IBD
Chrons UC
36
factors of UC
Start in rectum and through the entire colon Ulcerations, inflammations and shedding of the epithelium Mucosa is edematous and inflamed Abscesses that line the mucosa Ulcers bleed easily- bloody stools Narrowing of colon
37
clinical manifestations for Chrons disease
Steatorrhea Weight loss Crampy pain after meals Joint disorders Skin lesions Ocular disorders Oral ulcers
38
clinical manifestations for UC
Rectal bleeding Anemia Anorexia Hypoalbuminemia
39
clinical manifestations for both Chrons and UC
Fever (increased WBC and ESR) Abdominal pain Fatigue Diarrhea Weight loss Electrolyte Imbalance High-pitched bowel sounds
40
complications of Chrons
Intestinal obstruction/stricture Malnutrition Fistulas common Perforation/peritonitis Fluid and electrolyte imbalance
41
complications of UC
Toxic megacolon (colonic distension) Hemorrhage Perforation/peritonitis Fluid and electrolyte imbalance
42
diagnostic testing for IBD
CBC -Hgb and Hct ESR (Erythrocyte sedimentation rate) Electrolytes Albumin WBC CT scan Barium series Sigmoidoscopy/Colonoscopy
43
surgical options for Chrons
Strictureplasty Resection (recurrence common) Intestinal transplant
44
surgical options for UC
Total Colectomy with Ileoanal Reservoir Total Proctocolectomy with Permanent Ileostomy Total Proctocolectomy with continent Ileostomy
45
medications for IBD
Aminosalicylates – reduce inflammation -Sulfasalazine - photosensitivity Corticosteroids – reduce inflammation -Not for long-term use Immunosuppressants -Cyclosporine, methotrexate Immunomodulators – suppress immune response -mabs (infliximab), frequently given as infusions Antidiarrheals -May increase risk of toxic megacolon
46
nursing diagnoses for IBD
Diarrhea Fluid volume deficit Imbalanced nutrition: less than body requirements Disturbed body image
47
overall goals for IBD
Reducing inflammation Suppression of inappropriate immune response Rest diseased bowel Improve quality of life
48
nursing implementation for IBD
Monitor fluid and electrolytes Monitor I&Os closely Assess for s/s dehydration Teach high protein, high calorie, low fiber diet Teach s/s of complications Weight 1 – 2 times weekly Provide TPN during exacerbations and rest the bowel
49
evaluation for IBD
Exacerbations decreased and manageable Effective immune suppression with minimal complications Patient maintains quality of life Maintenance of body image

Medsurg Exam 3 (4 decks)

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